20-841.08. Prohibiting denial of occupational or physical therapist contract benefits
If a hospital service corporation or medical service corporation subscription contract provides coverage for occupational or physical therapy services, and provides both an in-network and out-of-network benefit, a service corporation shall not deny a claim for covered occupational or physical therapy services obtained out-of-network solely on the basis that a physician did not refer the insured to the occupational or physical therapist or prescribe specific occupational or physical therapy services. A service corporation may impose coinsurance, copayments, deductibles, dollar caps, limitations on the number of visits, provider network restrictions or other cost containment measures as a condition of coverage of occupational and physical therapy services for both in-network and out-of-network benefits.
Section: Previous 20-841.01 20-841.02 20-841.03 20-841.04 20-841.05 20-841.06 20-841.07 20-841.08 20-841.09 20-841.10 20-842 20-843 20-844 20-845 20-846 NextLast modified: October 13, 2016